Pa. hospital procedure offers new hope to heart patients

CHAMBERSBURG, PA. - Early on the morning of Feb. 22, Mary Willett woke up knowing she was having a heart attack.

There was crushing pain in her chest, nausea, clammy sweating "and my left arm seemed to be where I was feeling the most pain," the 66-year-old Chambersburg woman said.

"I had no doubts myself. Heart disease runs in my family," said Willett, adding that her father had a third, fatal heart attack when he was about her age.

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A few weeks earlier, Willett, a volunteer at Waynesboro (Pa.) Hospital, attended a seminar there on women's heart health.

"A lot of the things I learned there were still fresh in my mind," she said.

Willett's self-diagnosis was confirmed by the ambulance crew on the way to the emergency room of Chambersburg Hospital.

In Chambersburg Hospital's Cardio Cath Lab, Dr. Aylmer Tang inserted a catheter into Willett's femoral artery that snaked its way to the right coronary artery, which was completely blocked.

Sixty-one minutes after Willett's arrival, the blockage that caused the heart attack was opened with balloon angioplasty and a stent was inserted, procedures that were not available before Jan. 26.

"Time is muscle," said Tang, an interventional cardiologist with Franklin County Heart Center.

The longer it takes to open the blockage, the more heart muscle that dies for lack of blood flow, he said.

"When they got to the blockage ... I began to feel relief," Willett said.

Through the catheter, a physician can inject a dye used to track the blockage by X-ray, or ultrasound equipment to examine arteries from the inside out, Tang said.

Balloons to widen the artery and stents to keep it open also travel through the catheter, which is about as thick as the lead in a pencil.

Chambersburg is one of five hospitals in Pennsylvania allowed to perform angioplasty and stenting without also offering open heart surgery, according to Tang.

From Jan. 26 to the end of March, 144 people were treated at the hospital after suffering heart attacks or cardiac-related ailments, said registered nurse Cindy Green, the clinical manager of the hospital's cardiac cath lab. During that time, the angioplasty procedure was performed on 31 people who had heart attacks and 33 people who chose it as elective intervention, Green said.

Willett falls into both categories. Earlier this month, she was back in the hospital for an elective procedure to use balloon angioplasty and a stent to widen an artery that was 90 percent blocked.

The stainless steel stents, which resemble the small spring on a ball-point pen, can be coated with drugs that dissolve blood clots or prevent scar tissue from forming around the stent, Tang said.

The hospital's interventional cardiology program is affiliated with Pinnacle Health at Harrisburg (Pa.) Hospital. Patients who need open heart surgery can be flown by helicopter or taken by ambulance to that hospital or any other of their choice, Tang said.

"We haven't had to fly anyone out," said Tang. "We've been able to stabilize them enough to transport by ambulance."

Prior to the availability of angioplasty and stenting, Green said, 40 percent of cardiac patients were sent to other hospitals for treatment. Since then, the number has been about one in seven.

Other cardiac patients have benefited from angioplasty and stents, drug therapy or making changes in their lifestyle, such as beginning to exercise, Tang said.

Patients ranging in age from 34 to 81 have received angioplasty. Only five have been women, Green said.

"They figure it's their husbands that are going to have heart attacks, not them," Willett said.